Thanks in part to a zealotry that wraps itself in the guise of prohibiting public funding for abortions in any way, shape or form, many women in the military are unable to get basic reproductive health care, even if they become victims of sexual assault. Now two Democratic senators are trying to change that rule by introducing the Military Access to Reproductive Care and Health (MARCH) for Military Women Act.
Sen. Kirsten Gillibrand (D-N.Y.) and Rep. Louise Slaughter (D-N.Y.) recently introduced legislation (H.R. 2085) — the Military Access to Reproductive Care and Health (MARCH) for Military Women Act — that would allow servicewomen to use private funds to obtain abortion care at military health facilities and lift the ban that denies U.S. servicewomen and dependents insurance coverage for abortion services in cases of rape or incest, the Washington Independent reports. Under a policy first put in place during the Reagan administration, the provision of abortion services is prohibited at Department of Defense facilities, even if women use their own money to pay for the procedure. As a result, servicewomen must use local facilities or request combat leave to travel out of the country for abortion care (Resnick, Washington Independent, 6/7). In countries such as Afghanistan and Iraq, there are no local facilities where women can obtain safe abortion care, according to Gillibrand spokesperson Bethany Lesser (Tumulty, Air Force Times/USA Today, 6/6).
To deny a woman access to legal, safe reproductive health care, even if that woman pays out of pocket, and even if she is the victim of sexual assault, is beyond the pale. We need to treat the women who serve our country with respect, not deny them basic rights over bodily autonomy.
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The first nationwide study exploring the average wait time between an abortion care appointment and the procedure found most patients are waiting one week.
Seventy-six percent of patients were able to access abortion care within 7.6 days of making an appointment, with 7 percent of patients reporting delays of more than two weeks between setting an appointment and having the procedure.
In cases where care was delayed more than 14 days, patients cited three main factors: personal challenges, such as losing a job or falling behind on rent; needing a second-trimester procedure, which is less available than earlier abortion services; or living in a state with a mandatory waiting period.
The national findings come amid state-level research in Texas indicating that its abortion restrictions forced patients to drive farther and spend more to end their pregnancies. A recent Rewireanalysis found states bordering Texas had reported a surge in the number of out-of-state patients seeking abortion care.
“What we tend to hear about are the two-week or longer cases, or the women who can’t get in [for an appointment] because the wait is long and they’re beyond the gestational stage,” said Rachel K. Jones, lead author and principal research scientist with the Guttmacher Institute.
“So this is a little bit of a reality check,” she told Rewire in a phone interview. “For the women who do make it to a facility, providers are doing a good job of accommodating these women.”
Jones said the survey was the first asking patients about the time lapse between an appointment and procedure, so it’s impossible to gauge whether wait times have risen or fallen. The findings suggest that eliminating state-mandated waiting periods would permit patients to obtain abortion care sooner, Jones said.
Patients in 87 U.S. abortion facilities took the surveys between April 2014 and June 2015. Patients answered various questions, including how far they had traveled, why they chose the facility, and how long ago they’d called to make their appointment.
The study doesn’t capture those who might want abortion care, but didn’t make it to a clinic.
“If women [weren’t] able to get to a facility because there are too few of them or they’re too far way, then they’re not going to be in our study,” Jones said.
Fifty-four percent of respondents came from states without a forced abortion care waiting period. Twenty-two percent were from states with mandatory waits, and 24 percent lived in states with both a mandatory waiting period and forced counseling—common policies pushed by Republican-held state legislatures.
Most respondents lived at or below the poverty level, had experienced at least one personal challenge, such as a job loss in the past year, and had one or more children. Ninety percent were in the first trimester of pregnancy, and 46 percent paid cash for the procedure.
The findings echo research indicating that three quarters of abortion patients live below or around the poverty line, and 53 percent pay out of pocket for abortion care, likely causing further delays.
Jones noted that delays—such as needing to raise money—can push patients later into pregnancy, which further increases the cost and eliminates medication abortion, an early-stage option.
Recent research on Utah’s 72-hour forced waiting period showed the GOP-backed law didn’t dissuade the vast majority of patients, but made abortion care more costly and difficult to obtain.
The vast majority of countries pay for abortion care, making the United States a global outlier and putting it on par with the former Soviet republic of Kyrgyzstan and a handful of Balkan States, a new study in the journal Contraception finds.
A team of researchers conducted two rounds of surveys between 2011 and 2014 in 80 countries where abortion care is legal. They found that 59 countries, or 74 percent of those surveyed, either fully or partially cover terminations using public funding. The United States was one of only ten countries that limits federal funding for abortion care to exceptional cases, such as rape, incest, or life endangerment.
Among the 40 “high-income” countries included in the survey, 31 provided full or partial funding for abortion care—something the United States does not do.
Dr. Daniel Grossman, lead author and director of Advancing New Standards in Reproductive Health (ANSIRH) at the University of California (UC) San Francisco, said in a statement announcing the findings that this country’s public-funding restriction makes it a “stark outlier among countries where abortion is legal—especially among high-income nations.”
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The researchers call on policymakers to make affordable health care a priority.
The federal Hyde Amendment (first passed in 1976 and reauthorized every year thereafter) bans the use of federal dollars for abortion care, except for cases of rape, incest, or life endangerment. Seventeen states, as the researchers note, bridge this gap by spending state money on terminations for low-income residents. Of the 14.1 million women enrolled in Medicaid, fewer than half, or 6.7 million, live in states that cover abortion services with state funds.
This funding gap delays abortion care for some people with limited means, who need time to raise money for the procedure, researchers note.
As Jamila Taylor and Yamani Hernandez wrote last year for Rewire, “We have heard first-person accounts of low-income women selling their belongings, going hungry for weeks as they save up their grocery money, or risking eviction by using their rent money to pay for an abortion, because of the Hyde Amendment.”
Public insurance coverage of abortion remains controversial in the United States despite “evidence that cost may create a barrier to access,” the authors observe.
“Women in the US, including those with low incomes, should have access to the highest quality of care, including the full range of reproductive health services,” Grossman said in the statement. “This research indicates there is a global consensus that abortion care should be covered like other health care.”
Earlier research indicated that U.S. women attempting to self-induce abortion cited high cost as a reason.
The team of ANSIRH researchers and Ibis Reproductive Health uncovered a bit of good news, finding that some countries are loosening abortion laws and paying for the procedures.
“Uruguay, as well as Mexico City,” as co-author Kate Grindlay from Ibis Reproductive Health noted in a press release, “legalized abortion in the first trimester in the past decade, and in both cases the service is available free of charge in public hospitals or covered by national insurance.”